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Pernicious anemia (PA) and multiple sclerosis (MS) are both autoimmune disorders that cause fatigue, chronic pain, and physical handicaps, but that is where their similarities end. If that’s the case, why are so many doctors quick to diagnose multiple sclerosis before testing for simple vitamin B12 deficiency from pernicious anemia?

Pernicious anemia

Pernicious anemia (PA) is a medical condition that causes vitamin B12 deficiency. Over time, plummeting levels of vitamin B12 cause many debilitating symptoms- muscle pain, numbness, spasms, fatigue- all as a result of diminished red blood cells and impaired neurological functioning.

Without enough vitamin B12 in your system make plenty of healthy blood cells, you wind up feeling constantly tired, unfocused, disoriented, and depressed.

Vitamin B12 is also needed to produce myelin, a substance which protects your nerve cells from harm. That’s why pernicious anemia symptoms such as chronic pain, numbness, tingling in the arms and legs, and mobility difficulties may reveal a weakened nervous system caused by insufficient vitamin B12 levels.

Gradually, depleted vitamin B12 may cause further irreparable damage to the nervous system, in addition to increased risk for stroke, heart attack, and age-related dementia.

Only immediate vitamin B12 supplementation can reverse the symptoms of pernicious anemia, and prevent future relapses.

Multiple sclerosis

Multiple sclerosis also affects the nervous system, causing severe muscle pain, paralysis, and multiple neurological problems, some of which are similar to those experienced with pernicious anemia, only on a much higher level. People with MS struggle to manage relapses their whole lives, as it is a chronic illness that is difficult to control.

While pernicious anemia is easily treated with strict vitamin B12 supplementation, multiple sclerosis is much harder to manage, requiring various medications formulated to relieve specific symptoms.

What causes multiple sclerosis?

Scientists aren’t positive exactly what causes multiple sclerosis, but they do know that Caucasian females are the highest risk factor for MS.

Like pernicious anemia, multiple sclerosis symptoms may be part of an autoimmune disorder. Scientists believe that MS may be triggered by an infection, which the immune system begins to attack. After fighting off the infection, your body continues to attack, this time mistaking your nerve cells’ myelin- the same substance supported by vitamin B12- as a threat. So the cycle continues, creating damage to the central nervous system and prolonging debilitating symptoms of multiple sclerosis.

This article continues in Part 2, including symptoms of multiple sclerosis and diagnosis…

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Is it possible to get too much of a good thing, like too much vitamin B12, or too much of any vitamin, for that matter? Experts say yes- overdoing it on certain vitamins can cause vitamin toxicity, and the damage can range from annoying to severe. So before you down a bottle of vitamin C for immune system health, have a look at what health experts have to say about vitamin B12 and others.

If you don’t have enough vitamin B12 in your blood, then you may get vitamin B12 deficiency, which causes symptoms like

fatigue

depression

frequent forgetfulness

brain fog

low attention span

painful “pins and needles” and numbness in the hands and feet

stomach problems

decreased motor control

muscular weakness

impaired walking

Vitamin toxicity

According to the Institute of Medicine’s list of Tolerable Upper Intake Levels, certain vitamins like vitamin B12 are safe to take in mega doses, while other vitamins must be used in moderation. Taking too much of a certain vitamin may result in stomach discomfort, birth defects, or organ damage, according to many published studies.

Below is a list of vitamins, including recommended daily amount and risks of vitamin toxicity:

Vitamin B12

There is no upper limit for taking vitamin B12, according to the Institute of Medicine. That means that you can experiment with as much vitamin B12 as you like without causing any damage. Any amount that your body doesn’t use is excreted with your urine.

How much vitamin B12 do you need? Scientific evidence suggests that even people who don’t have vitamin B12 deficiency gain enormous health benefits- increased energy and mental alertness- by taking generous doses of vitamin B12.

One clinical study focusing on high-dose vitamin B12 found that taking 2,500-5,000 mcg of vitamin B12 every few days led to a 50%-80% increase in stamina, mental focus, and overall wellbeing after only a few weeks.

In a double-blind crossover study on vitamin B12 for treating tiredness, people who suffered daily fatigue but didn’t have vitamin B12 deficiency or chronic fatigue syndrome (CFS) experienced a boost of stamina, enhanced concentration skills, and improved mood after taking 5,000 mcg of vitamin B12 twice daily for two weeks.

Another study on people who didn’t have low vitamin B12 levels resulted in similar findings with varied doses of vitamin B12, from 3,000 mcg four times per week to 9,000 mcg daily.

Vitamin A

The upper limit for vitamin A supplementation is 3,000 IU for adult males and females. Health experts strongly advise meeting your vitamin A requirement through dietary sources like eggs, fortified milk, and liver, as opposed to pill form. Unless you have vitamin A deficiency, a risk factor for Crohn’s disease and celiac disease, there is no need to supplement with extra vitamin A.

Vitamin A toxicity may result in:

Nausea

Vomiting

Dizziness

Headache

Blurred vision

Muscular weakness

Skin peeling

Liver fibrosis

Birth defects

Damage to the central nervous system

Osteoporosis

18% increased risk for lung damage.

Vitamin C

The upper limit for vitamin C is 2,000 mg per day for adult males and females. Food source of vitamin C include citrus fruits, broccoli, sweet potatoes, and bell peppers. While vitamin C is essential for immune system health, there is inadequate scientific proof that taking extra amounts of vitamin C will help to ward off a cold or reduce cold symptoms.

Vitamin C toxicity may result in:

Diarrhea

Stomach cramps

Nausea

Flatulence

Kidney stones

Vitamin D

The Institute of Medicine recommends taking no more than 100 IU of vitamin D per day, unless you have vitamin D deficiency. While it is not possible to get too much vitamin D from sun exposure, taking excess vitamin D in pill form may cause vitamin toxicity.

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Do you have vitamin deficiency, such as vitamin B12 deficiency or vitamin D deficiency? How has vitamin deficiency impacted your life, now that you have been diagnosed? Are you aware of any vitamin toxicity symptoms that are not included in this article?

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If you feel fatigued, and suspect B12 deficiency, then see your doctor immediately. Before diagnosing vitamin B12 deficiency or pernicious anemia, your doctor will run a vitamin B12 blood test for vitamin B12 levels in your blood, in addition to measuring your red blood cells and homocysteine levels. Here are ten tests still used today to diagnose vitamin B12 and pernicious anemia.

Vitamin B12 deficiency symptoms:

Vitamin B12 deficiency can be difficult to catch, because it masks itself as many other conditions. Sometimes, B12 deficiency occurs as a secondary side effect of a primary illness like fibromyalgia, Crohn’s disease, or celiac disease. Other times, vitamin B12 deficiency symptoms are overlooked because of underlying conditions such as depression or diabetes.

The most common symptoms of vitamin B12 deficiency and pernicious anemia are:

Constant fatigue that is not relieved by sleep and does not result from overexertion

9) Intrinsic factor antibody test: Pernicious anemia is an autoimmune disorder in which sufferers are not able to product intrinsic factor, a necessary hormone for absorbing vitamin B12. Before diagnosing pernicious anemia, your doctor has to confirm the existence of an antibody in your system that inhibits intrinsic factor production, thereby causing vitamin B12 deficiency.

What about the Schilling test for vitamin B12 deficiency?

In the past, doctors have used the Schilling test to diagnose vitamin B12 deficiency. The Schilling test involves swallowing harmless, radioactive doses of vitamin B12 and tracking its progress in your body. However, because it involves fasting and the use of low-dose radiation, and because it may cause side effects like nausea, the Schilling test is rarely used.

Schilling test—a test in which a harmless amount of radiation is used to assess whether a vitamin B12 deficiency exists (rarely used)

If you suffer from Crohn’s disease, then check your vitamin B12levels often. One side effect of Crohn’s is pernicious anemia from vitamin B12 deficiency, in addition to Crohn’s symptoms like stomach cramping, diarrhea, and vomiting.

Not surprisingly, there are several reasons why vitamin B12 deficiency occurs withCrohn’s disease. Here are the four top reasons to check your vitamin B12 levels if you suffer from inflammatory bowel disease (IBD).

1- Symptoms of Crohn’s disease

Crohn’s disease, sometimes called ileitis, is an illness of the gastrointestinal (GI) tract that damages the bottommost part of the small intestinal, the terminal ileum. Symptoms of Crohn’s disease include chronic diarrhea caused by swelling of the small intestine, excruciating stomach cramps caused by intestinal strictures, fever, weight loss, and rectal bleeding.

The ileum is an important part of your digestive system for vitamin B12 absorption- without it, your body would be unable to extract vitamin B12 (cobalamin) and dispense it into your blood supply.

If Crohn’s disease has caused irreparable inflammation of your terminal ileum, you are at high risk for symptoms of vitamin B12 deficiency.

Vitamin B12 deficiency symptoms include:

Chronic fatigue

Depression

Anxiety

Short-term memory loss

Difficulty concentrating

Unclear thinking, or “brain fog”

Muscular twitching

Painful tingling and numbness in hands and feet

Sore, red tongue

Burning mouth sensations

Frequent clumsiness and stumbling

Once vitamin B12 deficiency is diagnosed, you may choose to take vitamin B12 shots, which are only available upon prescription.

In such cases, many opt for nonprescription OTC vitamin B12 for extra energy and mental stamina between vitamin B12 jabs.

4- Crohn’s and diet

People suffering from IBD (Crohn’s disease, ulcerative colitis) are required to follow restrictive diets excluding many foods that may irritate the digestive system. Fruits and vegetables that are uncooked may be red flag items, in addition to food sources of vitamin B12, such as meat, poultry, fish, milk, and eggs.

Additionally, stomachaches, nausea, and diarrhea make it hard for Crohn’s disease sufferers to eat nutritious, filling meals. As a result, people with Crohn’s often suffer from excess weight loss and malnourishment.

One of the leading types of malnourishment today is pernicious anemia from vitamin B12 deficiency.

Besides Crohn’s disease patients, other people at risk for vitamin B12 deficiency are:

You might not realize this, but your prescription medications could be giving you vitamin B12 deficiency; certain drugs drain B12 from your system and prevent you from absorbing vitamin B12- cobalamin- naturally from food sources. If you currently take any of the following medications, then you could be at risk for severe neurological damage.

Who is at risk for getting vitamin B12 deficiency?

Vitamin B12 is a water-soluble vitamin that occurs naturally in most animal protein sources; beef, chicken, turkey, fish, shellfish, mussels, eggs, milk, cheese, and yogurt are all rich in this essential B vitamin. Unless you follow a vegan diet, you probably ingest sufficient amounts of B12.

However, there are certain conditions, demographics, and lifestyle choices that can inhibit your body’s ability to absorb vitamin B12, regardless of how many hamburgers you eat. They are:

Being among the elderly

Suffering from gastrointestinal disease, such as Celiac, Crohn’s, or Irritable Bowel Syndrome (IBS)

Submitting to bariatric surgery

Lacking the ability to produce intrinsic factor, a hormone that aids in vitamin B12 absorption

Which medications deplete vitamin B12 levels?

Certain medications may prevent your body from digesting vitamin B12- heartburn drugs, for example. If you experience symptoms such as chronic fatigue, memory loss, depression, brain fog, tingling or prickly sensations in your hands and feet, or altered sense of taste, you might have depleted your stores of vitamin B12. The only way to be certain is to get your vitamin B12 levels checked with a blood screening.

A study done in Germany demonstrates that pregnant vegetarian women may not have an adequate supply of vitamin B12.This study was performed at the German Institute of Human Nutritrion in Postdam-Rehbrücke located in Nuthetal, Germany.

Vitamin B12 is only found naturally in foods derived from animal sources.However, many women are opting to restrict themselves to diets of predominantly plant origin in the belief that this will increase their lifespan and reduce the likelihood of death from heart disease.

Many pregnant vegetarians are choosing to include eggs and milk in their diets to supply them with vitamin B12, which is necessary for proper nerve formation in the fetus.Hence, their diet is referred to as the “lacto-ovo-vegetarian diet.”This particular study in Germany was done in reaction to other studies that showed that infants born to mothers on strictly vegetarian (vegan) diets were deficient in vitamin B12.

A woman who is B12 deficient is at a greater risk during pregnancy for pre-eclampsia and other pregnancy-related complications.Furthermore, the fetus is at greater risk for neural tube defects.A breast-fed infant of such a woman has a greater likelihood for developmental abnormalities and growth failure.

The purpose of the study in Germany was just to compare the blood plasma vitamin B12 levels of women who ate a traditional western diet (meat eaters) with women on a vegan diet and ovo-lacto-vegetarian diet.

Over one hundred pregnant women were recruited for the study and divided into three groups:The ovo-lacto-vegetarian group, the low-meat eater group, and the control group.The ovo-lacto-vegetarians were women who never ate meat at all in the three years prior to the study.The women in the control group were not on any diet (regular meat eaters). Blood samples were taken from all the women throughout their pregnancies.

As far as Body Mass Index (BMI) is concerned, the vegetarians and low-meat eaters had lower pre-pregnancy BMIs than the control group (meat eaters).

With regard to B12 concentrations, the vegetarian and low-meat eaters had much lower levels of vitamin B12. There was not much difference between the vegetarian and the low-meat eaters groups.

In summary, the study demonstrates that women on vegetarian diets are at greater risk for a B12 deficiency, thus placing their infants at a greater risk for neural tube defects.

If you are pregnant and do not eat much meat, it is highly recommended that you supplement your diet with vitamin B12.